Definitely don't give up hope! Based on the crazy increase in the number of
applications per applicant AMCAS reported (can't find the link with that data in it for some reason but there was also an increase in the
number of applicants—but I think that factor is less relevant at this stage), I expect WL movement will be at an all time high. This is based on the assumption that competitive applicants applied to more schools (as a precautionary measure), attended more interviews (as cost was no long a factor to turn down interviews at schools they are less interested in), and received more acceptances than they would in a number cycle (hypothetically by at least one). I've been talking to many current PittMed students, and the general consensus is WL movement is huge. It seems as though approx. 1/3 of the class (at a minimum) was once on the WL (note: I have no data to support this, that stat is just a guess based on talks I've had with students there). So given the context of this admissions cycle I mentioned earlier, I propose WL movement might be even higher that typical.
Now, as for how the WL works, see page 4:
https://www.medadmissions.pitt.edu/sites/default/files/UPSOM_BYLAWS_approved_1_22_2020_0.pdf
Rankings are only factored in for the
initial decision and then what tier WL you are (which they don't tell you, but WL tier 2 is not a DOA delegation based on the wording of that PDF). A quote: "Applicants will be nominated from the waitlist by a subcommittee." Therefore, it is in your best interest to write a letter of interest/intent/update as to potentially spark a nomination from a committee member, as this might prompt them to review your application because you are showing continued interest. I got off the WL because of a PSTP A, but they still had to present me as a nomination to the WL committee for them to approve. This means, if my WL nomination for an A would not have been approved by the committee, I would have likely been rejected by the PSTP even if the PSTP wanted to accept me. PSTP functioned as a "nominator" in my case.
If I got anything incorrect here, please let me know! I don't want to spread misinformation.